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澳大利亚新南威尔士州住院原住民和非原住民学龄前儿童非故意伤害性中毒的人口学和临床特征:一项人群数据关联研究。

Demographic and clinical characteristics of hospitalised unintentional poisoning in Aboriginal and non-Aboriginal preschool children in New South Wales, Australia: a population data linkage study.

机构信息

Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.

Department of Community Child Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.

出版信息

BMJ Open. 2019 Jan 30;9(1):e022633. doi: 10.1136/bmjopen-2018-022633.

Abstract

OBJECTIVES

To investigate differences in demographic and clinical characteristics of Aboriginal and non-Aboriginal children aged 0-4 years hospitalised for unintentional poisoning in New South Wales (NSW), Australia.

DESIGN AND SETTING

Retrospective whole-of-population cohort analysis of linked hospital and mortality data for 2000-2014.

PARTICIPANTS

All children (Aboriginal and non-Aboriginal) under the age of 5 years who were born in a hospital in NSW from 2000 to 2009.

OUTCOMES

The primary outcome was hospitalisation for unintentional poisoning. Logistic regression was used to estimate odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children. Poisoning agents and clinical outcomes were compared by Aboriginality.

RESULTS

The cohort included 767 119 children, including 28 528 (3.7%) Aboriginal children. Aboriginal children had approximately three times higher rates of hospitalised poisoning (1.34%) compared with non-Aboriginal children (0.41%). Poisoning incidence peaked at 2-3 years of age. Male sex, socioeconomic disadvantage and geographical remoteness were associated with higher odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children, but associations with disadvantage and remoteness were statistically significant only for non-Aboriginal children. Most (83%) poisonings were caused by pharmaceutical agents. Few Aboriginal and non-Aboriginal children had repeat admissions for poisoning; most had a length of stay of 1 day or less. Only 8% of poisoning admissions involved contact with a social worker.

CONCLUSION

Commonly used medications in the general population contribute to poisonings among both Aboriginal and non-Aboriginal preschool-aged children. This study highlights a need to develop culturally safe poisoning prevention strategies and policies.

摘要

目的

调查澳大利亚新南威尔士州(NSW)因意外中毒住院的 0-4 岁原住民和非原住民儿童在人口统计学和临床特征方面的差异。

设计和设置

2000-2014 年,对医院和死亡率相关数据进行回顾性全人群队列分析。

参与者

2000 年至 2009 年期间,在 NSW 医院出生的所有 5 岁以下儿童(原住民和非原住民)。

结果

主要结局为因意外中毒住院。采用 logistic 回归估计原住民和非原住民儿童中毒住院的几率。比较了原住民和非原住民的中毒药物和临床结局。

结果

该队列包括 767119 名儿童,其中 28528 名(3.7%)为原住民儿童。原住民儿童中毒住院率(1.34%)是非原住民儿童(0.41%)的近三倍。中毒发病率在 2-3 岁时达到峰值。男性、社会经济劣势和地理位置偏远与原住民和非原住民儿童中毒住院的几率增加相关,但劣势和偏远地区与非原住民儿童中毒住院的关联具有统计学意义。大多数(83%)中毒是由药物引起的。少数原住民和非原住民儿童因中毒多次住院;大多数住院时间为 1 天或更短。只有 8%的中毒入院涉及与社工的接触。

结论

普通人群中常用的药物也会导致原住民和非原住民学龄前儿童中毒。本研究强调需要制定文化安全的中毒预防策略和政策。

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